In the first week of the winter vaccination programme, 27,000 people have come forward to get their flu vaccine, which is a great response ((writes Edinburgh Integration Joint Board member and Forth Councillor GEORGE GORDON).
We’ve all seen the devastating effect the pandemic has had in the past 18 months so it’s really important we all play our part to limit the impact this winter.
This is a personal appeal to encourage everyone who’s eligible to get their flu vaccination this winter. COVID-19 has not gone away so it’s more important than ever to protect yourself by getting the vaccination and do your bit to ease the pressure on social care, GP surgeries and hospitals over winter.
Many of you will already have received a letter either with an appointment or asking you to book one online. I know there’s been an issue with the scheduling of some flu appointments via the national booking system.
This means some people’s appointments are not as local as would have been expected, and a few cases where people who are housebound have been asked to go to an appointment. I know how concerning this is for people who cannot travel.
If you have received a letter with an appointment that you are unable to attend, you can rearrange your appointment for a more local venue by going online at nhsinform.scot/flu-vaccine/invitations-and-appointments/rearrange-your-flu-vaccine-appointmen or ring the national flu vaccination helpline on 0800 030 8013 for help to re-book.
More local appointments are now available for people who find it difficult to travel. If you are housebound and normally get your flu jab at home then you will get it at home again this year, even if you’ve received an appointment letter.
It’s really good to see that so many people have been turning out to get their vaccinations. The Royal Highland Centre site experienced a slight delay in topping up vaccination stocks on Tuesday morning (5 October) due to the level of demand across other sites and some people were asked to return the following day.
This was resolved within an hour and I can assure you that we have good vaccine stocks in Edinburgh.
Across Scotland, GP surgeries are no longer responsible for flu vaccinations for their patients. Now, health and social care partnerships manage the flu programme. In Edinburgh we have a range of drive through and walk through clinics for adults which will open at weekends during October and November.
Edinburgh’s main site is in Lowland Hall at the Royal Highland Centre which is open seven days a week and easy to access by public transport (buses 100, 200 and 400). We also have small local clinics for people who can’t make their way to Ingliston.
Children have received a letter for their parents or carers about their vaccine. If it’s been six months since your second dose of the COVID vaccine, you may also get your COVID vaccine booster at the same time as your flu vaccine.
It’s a massive programme and this year there’s more people than ever eligible to get a vaccine which is great news. You can now get the vaccine if you’re over 50, pregnant, an unpaid carer, at risk because of an existing health condition, or because of the job that you do. You can check if you are eligible for a flu vaccine, or find more information, at nhsinform.scot/flu.
I’d really encourage you to take up that offer – go to your vaccination appointment if you have been given one or book an appointment on the online portal if you’ve been asked to do that.
Please don’t be in any doubt – flu is serious. Getting the vaccine will protect you, your family and friends, and also our vital NHS and social care services.
“The current situation is not sustainable; it is dangerous for patients and becoming incredibly difficult for staff.” – Dr John Thomson, Vice President of the Royal College of Emergency Medicine Scotland
A substantial new investment of over £300 million in hospital and community care has been unveiled to help tackle what is anticipated to be the toughest winter the NHS and social care system has ever faced.
The new multi-year funding will support a range of measures to maximise capacity in our hospitals and primary care, reduce delayed discharges, improve pay for social care staff, and ensure those in the community who need support receive effective and responsive care.
The NHS and Care Winter Package of additional funding includes:
Recruiting 1,000 additional NHS staff to support multi-disciplinary working
£40 million for ‘step-down’ care to enable hospital patients to temporarily enter care homes, or receive additional care at home support, with no financial liability to the individual or their family towards the cost of the care home
Over £60 million to maximise the capacity of care at home services
Up to £48 million will be made available to increase the hourly rate of social care staff to match new NHS band 2 staff
£20 million to enhance Multi-Disciplinary Teams, enable more social work assessments to be carried out and support joint working between health and social care
£28 million of additional funding to support primary care
£4.5 million available to Health Boards to attract at least 200 registered nurses from outwith Scotland by March 2022
£4 million to help staff with their practical and emotional needs, including pastoral care and other measures to aid rest and recuperation
Health Secretary Humza Yousaf said: “As the winter period approaches, it is vital that we do all we can to maximise the capacity of the NHS and social care system. That’s why I’m setting out our £300 million NHS and Care Winter Package today.
“We cannot look at the NHS in isolation we must take a whole systems approach and these measures will help alleviate pressure across the NHS and social care.
“This significant new investment will help get people the care they need as quickly as possible this winter. Bolstering the caring workforce by increasing their numbers, providing them with additional support, and increasing the wages of social care staff.
“We’ve previously provided funding to ensure that adult social care staff are paid at least the real living wage. Today we’re going further and our new investment will ensure that adult social care staff who are currently paid the real living wage will get a pay rise of over 5%
“Measures I have announced today will help patients whose discharge has been delayed waiting for care and help get them out of hospital and on to the next stage in their care. This helps the individual by getting them the right care, and helps the wider system by ensuring the hospital capacity is being used by those who need that specialist level of clinical care.
“This £300 million of new funding will also fund increases in social care capacity in the community and in primary care – helping to ease the pressure on unpaid carers.
“Our NHS, social care staff and social work staff have been remarkable throughout the pandemic and today’s additional investment will help support them to deliver care to people across Scotland this winter.”
Meanwhile,the latest Emergency Department performance figures for Scotland published by the Scottish Governmentyesterday for August 2021 show that four-hour performance has deteriorated for the fourth consecutive month, again reaching a record low – while the number of patients staying in a major Emergency Department for 12-hours or more reaches a record high.
In August 2021 there were 117,552 attendances to major Emergency Departments across Scotland.
Data show that four-hour performance reached a new record low, with 75.4% of patients being seen within four-hours. One in four patients stayed in a major Emergency Department for four-hours or more before being admitted, transferred or discharged.
The number of 12-hour stays in August 2021 nearly doubled when compared to July 2021. 1,346 patients stayed in a major Emergency Department for 12-hours or more, compared to 760 in July 2021. This figure increased for the fourth consecutive month and it is the highest number of 12-hour stays since records began.
Data also show that 5,279 patients spent eight hours or more in a major Emergency Department. This is the highest figure since records began. The number of patients delayed by eight-hours or more increased for the fourth consecutive month.
Dr John Thomson, Vice President of the Royal College of Emergency Medicine Scotland, said: “The challenge for health care workers is growing significantly. In Scotland, the army have been called in to assist the ambulance services.
“In Emergency Departments, long stays are rising drastically, and one in four patients are staying in an Emergency Department for more than four-hours. It is extremely worrying. These pressures are likely to mount further, and performance deteriorate even more as we head into winter.
“We are seriously concerned about patient safety. Long stays put patients at risk, particularly vulnerable patients, and especially with covid still present in the community. We urgently need a plan to increase flow throughout the hospital, to reduce exit block, to prevent crowding, and to ensure that patients who need it can quickly be moved into a bed for their care.
“The current situation is not sustainable; it is dangerous for patients and becoming incredibly difficult for staff.
“We welcome this afternoon’s announcement by the Secretary of State for Health and Social Care, Humza Yousaf MSP, including the recruitment of more staff and funding for hospital and community care. We hope that these measures will begin to alleviate pressures across the health system, and in particular reduce ambulance handover delays, long stays in Emergency Departments and exit block in our hospitals.
“However, while we welcome this investment, short-term cash injections do little to resolve long-term problems. We must see a long-term workforce plan that includes measures to retain health workers, particularly Emergency Medicine staff, as well as a long-term strategy for social care.”
Responding to the Scottish Government’s announcement to uplift care workers pay to just over £10 an hour, GMB Scotland Secretary Louise Gilmour said:“If we want to tackle the understaffing crisis in social care then we need to substantially increase the basic rate of pay, and for GMB that mean’s a £15 an hour minimum.
“Many of our frontline services are already being delivered on the back of wages of just under or over £10 an hour, and we know this isn’t nearly enough.
“To transform social care for the people who need it and the people who deliver it, particularly as we roll-out a national care service, then we must go further.”
The Scottish Government may also be facing industrial action from nursing staff over the winter …
NHS pay dispute in Scotland: Royal College of Nursing members to be asked about willingness to take industrial action
RCN members working for NHS Scotland are to be asked what industrial action they would be willing to take in support of their ongoing trade dispute with the Scottish government and NHS employers over pay.
The indicative ballot will open on 12 October and close on 8 November.
Eligible members will receive information on the different forms of industrial action.
The indicative ballot will be run by Civica, the independent scrutineer that organised the consultative ballot earlier this year. Eligible members will receive an email from Civica with a personal link to the online voting site on Tuesday 12 October. Weekly reminder emails will also be sent.
The result of the indicative ballot will not formally authorise industrial action. It will be used to inform the next steps RCN members might take.
Julie Lamberth, Chair of the RCN Scotland Board, said: “Industrial action is always a last resort but the current staffing challenges are causing unacceptable risks to patients and staff. The Scottish government has the opportunity to do the right thing by nursing.
“I would urge all eligible RCN members to seek out the available information on what taking industrial action means and what the implications of doing so might be. We need each member to make up their own mind and have their say in the ballot.”
Colin Poolman, RCN Scotland Director, added: “This is your chance to speak up – for your patients and your colleagues. Many of you rejected the pay offer and you know the link between fair pay and safe staffing.
“This is your opportunity to tell us what action you are prepared to take. To let the Scottish government know that the time to protect patient safety and value the safety critical role of nursing is now.”
Midwives are being driven out of the NHS by understaffing and fears they can’t deliver safe care to women in the current system, according to a new survey of its members by the Royal College of Midwives (RCM).
The College is warning of a ‘midwife exodus’ as it publishes the results of its annual member experiences of work survey. Over half of midwives surveyed said they were considering leaving their job as a midwife with 57% saying they would leave the NHS in the next year.
Of those midwives who either have left or were considering leaving, more than eight out of 10 were concerned about staffing levels and two-thirds were not satisfied with the quality of care they are currently able to deliver.
Alarmingly, the highest level of dissatisfaction among those surveyed came from midwives who had only worked for five years or less in the NHS. This will have a significantly detrimental impact on workforce planning and, says the RCM, the ability of maternity services across the country to provide acceptable levels of safe, quality care.
The RCM’s General Secretary and Chief Executive, Gill Walton, said: “Every midwife and maternity support worker goes to work to provide safe, quality care. That so many feel that understaffing means they are unable to do so is deeply worrying.
“What these numbers suggest is a midwife exodus, which will leave already-struggling services on their knees. Quite rightly, there is a strong focus on improving maternity safety, but there is a risk that the Government is ignoring the essential ingredient to that: having the right staff, in the right place.
“Investment and programmes to improve safety in maternity services hang in the balance here, because without adequate numbers of staff with are fighting a losing battle. Every safety report cites understaffing as an issue that is comprising the delivery of safe care, but when are the Government going to take note?
“We are calling on the Government to listen to those best advised and work with us to improve retention and recruitment. All NHS organisations must urgently review their maternity staffing levels using a recognised workforce planning tool to ensure staffing reflects the workload.”
A report published by NHS Digital in July revealed the number of NHS midwives working in England in May had fallen by almost 300 in just two months. This is the fastest fall for these two months for any of the years listed in the NHS report, which goes back to 20 years say the RCM.
Burnout among midwives and all maternity staff is higher than ever, particularly after COVID-19 which saw an increase in sickness absence adding to a pre-existing shortage of 2,000 midwives in England alone.
Last week leaked results of an NHS national staff survey showed a sharp drop in those who believe their health and wellbeing is being supported by their employer. This is echoed in the RCM survey, with over half of respondents saying that they did not feel valued by their employer.
Almost all (92%) of midwives and maternity support workers (MSW) said that they did not feel their work was valued by the current Government.
Gill added: “Not a day goes by that we don’t hear of a maternity service having to close temporarily, suspend services or divert women to other maternity units just because there simply aren’t enough midwives. This can’t continue because we know it compromises safety and means women don’t always get the safe positive pregnancy and birth experience that they should.
“It’s also having a shocking impact on maternity staff themselves. A shortage of midwives has undoubtedly worsened rates of physical and mental burnout among our members. Morale among staff is low and has been worsened by the recent pay award in England.
“Sadly, this survey shows that many midwives and MSWs have had enough. They are feeling very fragile and are simply at breaking point. Enormous demands are being made on midwives and the services they work for, yet investment in these services from the Government remains inadequate to provide the safe, high-quality care that women deserve.
“We have previously advised the Government on what can be done to begin to address this situation which hasn’t happened overnight. Prior to the pandemic the RCM has voiced concerns and solutions to the recruitment and retention issues faced by UK maternity services, and we are happy to do that again, but we are now sadly at crisis point.
“That is today we are again calling on the Government and NHS Employers to take action immediate to keep midwives in midwifery before it’s too late.”
The Coronavirus vaccine certification scheme comes into effect today in Scotland meaning people will have to show proof of their vaccination status to enter some events and higher risk venues.
People attending a range of late night venues and larger indoor and outdoor live events, such as music festivals or large sporting events, will be required to show staff their Covid status. This can be done via the NHS Scotland Covid Status App released yesterday on their mobile device or using the paper certificate.
Following consultation with businesses affected a grace period has been agreed until Monday October 18th before the scheme is legally enforced. The legal requirement for businesses to keep information about certification status confidential and not use it for other purposes comes into effect today.
Deputy First Minister John Swinney said: “We know from expert public health analysis that we must do all we can to stem the rise in cases and reduce the pressure on the NHS.
“Vaccine certificates have a role to play as part of a wider package of measures. They add a further layer of protection in certain higher risk settings.
“This is a very limited scheme and we hope this will allow businesses to remain open and prevent any further restrictions as we head into autumn and winter.
“I would encourage people to to download the NHS Scotland Covid Status App and help our drive to keep the virus under control.
“Scotland is not unique in introducing such an approach. Certification schemes are in place across Europe, including Ireland and France, and the Welsh Government is also planning similar measures.
“I also want to ensure that as many people get vaccinated as possible and particularly to increase uptake in the younger age cohort, so anything that helps to incentivise that is helpful.”
The Scottish Government will continue to work with the sectors affected and updated guidance has been published to help ensure the smooth introduction of the scheme.
People in Scotland can download the NHS Scotland Covid Status App via their mobile device. A paper certificate or the downloadable PDF is also available from NHS Inform.
The Regulations which came into force at 5am today and must be reviewed every three weeks as part of the wider review of Coronavirus Regulations.
There are currently no plans to introduce certification for the wider hospitality industry but this will be kept under review over the autumn and winter months.
Exemptions to the scheme include under 18s, participants in vaccine trials, as well as people who cannot be vaccinated for medical reasons and people working or performing in the venues.
Officials are currently working with other UK jurisdictions to help ensure people vaccinated outside Scotland can still enter the venues affected with proof of their vaccine status.
The NHS Scotland Covid Status App is available for download from NHS Inform:
The Covid-19 vaccination programme has made excellent progress in vaccinating a large majority of the adult population in Scotland, according to a new report published today (30 September) by Audit Scotland.
By 17 September, more than 90 per cent of people aged 18 or over had received at least one Covid-19 vaccine. Levels of vaccine wastage have been low, and the programme has helped reduce the number of people getting severely ill and dying.
However, uptake has been lower amongst young people, those in the most deprived areas and those from some ethnic minority backgrounds.
The vaccine rollout has also relied on a temporary staff drawn from across the NHS. This is an expensive model and the Scottish Government recognises that it needs a longer-term solution.
NHS boards and health and social care partnerships currently expect vaccine delivery costs to be around £223 million in 2021/22. But the final cost for this year will depend on clinical advice issued by the Joint Committee on Vaccination and Immunisation, so it could differ substantially from the current estimate.
Stephen Boyle, Auditor General for Scotland, said: “The delivery of the vaccination programme has been a success so far, with good collaboration and new digital tools developed to help the process.
“Early scenario planning by the Scottish Government and NHS boards has allowed them to continue to react quickly to formal UK clinical advice.
“There is now an opportunity for the Scottish Government to use what’s it’s learned to manage the challenges of the next part of the vaccine programme, and the wider delivery of NHS services.”
Letters offering a coronavirus (COVID-19) vaccination to all 12-15 year olds who haven’t yet received their jab are arriving from today (Monday).
Drop-in clinics have been available to this age group for the last week and now scheduled appointments – starting this week – are being issued to all those eligible. The letters will contain an information leaflet, which all parents and carers should read with their children so they can make an informed decision about getting the vaccine. This information is also available online at NHS Inform.
Parents and carers are encouraged to accompany their children to community-based appointments where possible so any questions they may have can be raised with staff on site.
In some rural areas, this age group will be offered the jabs through their school vaccination programme instead of a community setting and they will receive letters and leaflets home from school. In these situations, parents and carers who have questions they wish to discuss with a vaccinator before the school session can go to any drop-in clinic and ask for advice.
Health Secretary Humza Yousaf said: “The roll out of the COVID-19 vaccine to all children and young people aged 12-15 marks a significant milestone in the vaccination programme.
“It has been demonstrated that COVID-19 vaccines are safe and effective in this age group, and vaccination offers the best chance of protecting young people from COVID-19 and preventing further disruption to education. Many countries around the world have already been safely vaccinating children and young people in this age group.
“Getting the COVID-19 vaccine is a decision to be made jointly between parents or carers and their children, but it’s really important to use reliable and trusted sources such as NHS Inform when making a decision and assessing the potential benefits, risks and side effects. Individual choice should be respected for the decisions young people and their parents or carers make in accepting, or not accepting the vaccine offer.
“Where possible, parents or carers are welcome to attend appointments with their children and both can ask questions about any queries they have before the vaccination is given.
“I would like to thank all of the vaccinators and vaccine site staff who have worked so hard to get us to this stage of the COVID-19 vaccine programme.”
Children aged 12-15 who have specific underlying conditions or disabilities are already covered by previous JCVI advice and will be offered two doses of the vaccine, eight weeks apart.
The BDA fully supports community water fluoridation as a safe and effective public health intervention, as part of a package of measures to improve dental health, where technically feasible and appropriate for local needs. The Health and Care Bill, currently before Parliament, is set to simplify the rollout of the policy in England. Dentist leaders are now urging all 4 UK administrations to restate their positions on water fluoridation in light of the statement.
Public Health England modelling shows water fluoridation more than pays for itself in medium term, owing to reduction in treatment need. £1 spent equates to £12.71 savings in five years, rising to £21.98 in ten. The BDA has stressed that upfront investment by Government is vital to unlock these benefits.
In their statement, the four UK CMOs recognise water fluoridation should be seen as a complementary strategy, and not a substitute for regular dental check-ups and other effective methods of increasing fluoride use.
The BDA backs a joined-up approach in which tried and tested policies like water fluoridation and supervised tooth brushing in early years settings are expanded, with parallel effort applied to rebuilding high street dental services.
Oral health inequality is anticipated to widen, given combination of unprecedented access problems, the suspension and ongoing disruption to public health programmes and changes to dietary habits since the start of the pandemic. Over 30 million appointments have been lost in NHS dentistry since lockdown, in England alone.
Around 5.8 million people in England receive fluoridated water, the lion’s share artificially added, but in some locations the appropriate level exists naturally within local water supplies.
British Dental Association Chair Eddie Crouch said: “Every dentist will thank the CMOs for recognising the lasting benefits water fluoridation could bring to the nation’s oral health.
“However, these gains are purely theoretical without upfront investment. Spending here will pay for itself, and Ministers need to show they are willing to seize the moment.
“We need a joined-up approach. COVID has left millions unable to access care, and deep inequalities are now set to widen. The four Governments must double down on tried and tested policies while rebuilding the services millions depend on.”
More than 10 million COVID-19 PCR tests have now been carried out in Scotland over the past 19 months since testing got underway.
The tests, which include those processed at the three NHS regional hubs set up around Scotland, have now reached 10,017,000. They also include the four-nations network of Lighthouse laboratories, partner laboratories and testing sites.
More than one million tests have also been conducted by the Scottish Ambulance service at mobile testing units around the country.
Health Secretary Humza Yousaf said: “Reaching ten million tests is a major milestone and recognition of the hard work and dedication of our testing teams across the country.
“Testing has a vital role to play as restrictions are phased out and we learn to live with the virus.
“It may be tempting to think as vaccinations increase and cases drop, that testing will become less important. In fact, this will only make it more important to spot and prevent new outbreaks as cases emerge. We know from our experience just how quickly one outbreak can lead to another.
“The ability to quickly identify new outbreaks and put appropriate measures in place will remain at the heart of our strategy to help break chains of transmission.”
All adults are encouraged to take a PCR test if they have any one of the three symptoms of coronavirus. These are a high temperature or fever, a new continuous cough, as well as any loss of, or change in sense of smell or taste.
People are also encouraged to take two rapid (lateral flow) tests a week, regardless of whether they have symptoms.
https://youtu.be/X0Kj8dD_X_M
Three regional hubs were established this year at Gartnavel hospital in Glasgow (West) operated by NHS Greater Glasgow and Clyde, Foresterhill in Aberdeen (North) operated by NHS Grampian and Lauriston Place in Edinburgh (East), operated by NHS Lothian, to increase capacity.
The 10,017,000 figure for tests comprises those processed through to midnight on September 20.
– Covid-19 booster vaccinations get underway today
– Lothian launches drop-in clinics for 12 to 15-year-olds
Residents in care homes for older people are the first to be offered coronavirus (COVID-19) booster vaccinations from today (Monday).
This group will be offered both flu and COVID-19 booster vaccines after the Joint Committee on Vaccination and Immunisation advised that they could be given alongside one another.
From tomorrow (Tuesday 21 September) frontline health and social care workers are able to book an appointment for a booster jab online at NHS Inform. The portal can be used by all health and social care workers to book a flu vaccine.
Adults aged 70 years and over and those 16 years and over who are on the highest risk list (previously known as the shielding list) will begin to be contacted by letter or by their GP from the end of September.
People on the highest risk list who were severely immunosuppressed at the time of their last COVID-19 vaccination will be offered a third primary dose instead.
Other eligible groups – including all those aged 16 to 49 years with underlying health conditions, adult carers, unpaid and young carers, adult household contacts of immunosuppressed individuals and all adults over 50 – will be able to book an appointment online from October.
Meanwhile, also from today (Monday) children and young people aged 12 -15 years old can go to drop-in clinics for a vaccination if they wish to get their jab before they receive their letter inviting them for a scheduled appointment. Everyone in this age group will be invited for vaccination at a community based clinic or a school delivery session from 27 September.
Heath Secretary Humza Yousaf said: “I am pleased to see the booster programme getting underway for residents in care homes for older people, offering longer lasting protection against severe COVID-19 illness.
“The booster programme will run alongside our biggest ever flu vaccine programme as both of these programmes are important for individual and for public health and wherever possible, those eligible will be offered COVID-19 booster and flu vaccines together.
“We are also starting vaccination of 12-15 year olds after Scottish Ministers accepted advice from the four UK Chief Medical Officers. This group can now head to drop-in clinics for their jabs or wait for a letter offering them a scheduled appointment.”
NHS Lothian launches drop-in clinics for 12 to 15-year-olds
Young people aged 12 to 15 will be able to get a COVID-19 vaccine at drop-in clinics across Lothian from today (September 20).
Mass clinics in West Lothian, Edinburgh and Midlothian will open their doors to young people as part of the latest phase of the national vaccination programme.
Pyramids, Gorebridge and Lowland Hall vaccination clinics will be the first in Lothian to administer the lifesaving vaccine, before more clinics are added to the list over coming days.
Pat Wynne, Director of Nursing for Primary and Community Care, NHS Lothian said: “We are delighted to offer drop-in clinics for young people aged 12-15.
“These clinics will enable young people to attend, without a prior appointment to receive their vaccination.
“We recognise that young people, as well as their parents and guardians may have questions regarding the COVID vaccination and we encourage them to visit the pages on NHS Inform where there is a range of information available.
“Alongside this, our teams at Pyramids, Gorebridge and Lowland Hall are one hand to answer any questions people may have.
“Vaccination remains critically important in the continued fight against COVID-19 and we welcome the further expansion of the vaccination programme across Lothian.”
The clinics are opening their doors following the publication and government acceptance of the advice of the four Chief Medical Officers (CMOs) to offer a single dose of the COVID vaccine to all healthy 12-15-year-olds.
Young people do not need to be registered with a GP to attend, however it is requested that they are accompanied by their parent or guardian.
As well as the drop-in clinics for 12-15’s, NHS Lothian continues to operate a range of COVID vaccination clinics in locations across Lothian.
Mr Wynne added: “We continue to offer vaccination clinics across Lothian for anyone who requires a first dose of the vaccine, or who is now due their second dose. I would urge anyone who has still to be vaccinated to pop along.”
